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seminal vesicles

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User
Posted 23 Jun 2016 at 06:51
Well, histolgy in.....no lymph node spread but upgrade from 2a to 3b. Spread to seminal vesicles, and one little breakout. But they said negative margins all round, and all cancer removed.

Bit of a shock.
Ive since read that spread to seminals means more likely to recur, even if all cancer removed......?
User
Posted 23 Jun 2016 at 22:57
D

Cannot answer your question but a reply with bump you up the list.

Thanks Chris
User
Posted 24 Jun 2016 at 16:31
Hi David, Just had my post op meeting today - clear margins but upgraded also to stage 3 and referred to oncologist for discussion. ' 3 cm tumour on edge of prostate did not show up on MRI or biopsy ' ( only 1 hit in 12). The good news was although they hadn't said previously, I also had some nerve saving. Good luck!
User
Posted 25 Jun 2016 at 13:37

DW, you could look at Jaypeeca, Christoff, Sanders, Louise1969 or Peterandali for starters - or just put 'seminal vesicles' into the search box and read down all the specific posts where it has been mentioned

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
Posted 23 Jun 2016 at 22:57
D

Cannot answer your question but a reply with bump you up the list.

Thanks Chris
User
Posted 24 Jun 2016 at 01:13

Yes, statistically more likely to have a recurrence but not a certainty. John had sv involvement and it took 2 years for him to accept he needed salvage RT, once his PSA started to creep up. Some hospitals would offer adjuvant RT to men with sv involvement but the fact that you still got negative margins is a good sign.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 24 Jun 2016 at 04:54

Thank you Lyn, as I lie awake at 4am worrying and a bit tearful, that helps. Yes, the clear margins is what im hanging onto. I dont get how the mri graded it at T1, then biopsy T2a, all looking good for a straitforward RP, only to find so juch more!
Wait and see, I guess, but to have it so changed is a real shock.

User
Posted 24 Jun 2016 at 07:21

The scans are not perfect, you are talking about tiny groups of microscopic cells. On the other hand, your first opinion doctor's view that you needed to lose the nerves on one side has turned out to be correct so he had seen something that made him think that. According to John's scan, he didn't have any cancer at all and yet the surgeon advised open RP so that he could 'get his hands in' - when they got in there it was in every bit of his prostate and off into his bladder.

No need to be teary though, there are plenty of members on here that have had sv involvement but continue to have undetectable PSA and never need any further treatment. Just assume you will be one of them :-)

Edited by member 24 Jun 2016 at 07:27  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 24 Jun 2016 at 12:31

Thanks Lynn. You know I had both nerves saved? The first one just wasn't sure how close the growth was to the edge. 'Live' pathology showed it was safe to leave both. Hope so.

User
Posted 24 Jun 2016 at 12:59

Yes I remembered - that was my point. They wouldn't have left the nerve bundle if they suspected sv involvement or a breach so in hindsight the 'live' pathology may have been less reliable than the first surgeon's instincts. I worry that some of these specialists are far too over-confident about their skills and fail to explain to patients what the risks are.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 24 Jun 2016 at 14:56

The margins to the nerves were clear though..

User
Posted 24 Jun 2016 at 16:01

And hopefully your first PSA will come in as undetectable and then will continue to be so for many years. There is no point fretting about it unless it happens; that's what my OH and dad say, anyway!

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 24 Jun 2016 at 16:31
Hi David, Just had my post op meeting today - clear margins but upgraded also to stage 3 and referred to oncologist for discussion. ' 3 cm tumour on edge of prostate did not show up on MRI or biopsy ' ( only 1 hit in 12). The good news was although they hadn't said previously, I also had some nerve saving. Good luck!
User
Posted 24 Jun 2016 at 20:14
You are right Lyn!
User
Posted 25 Jun 2016 at 07:57

What I dont get yet is why does spread to the seminal vesicles make it worse, if they are removed and had negative margins?

User
Posted 25 Jun 2016 at 10:16
And what are you planning to do next, if anything?
User
Posted 25 Jun 2016 at 10:19
Lyn, could you point me to some of these members you refer to above? Thank you.
User
Posted 25 Jun 2016 at 12:04
It seems to be one of 3 high risk of recurrence indicators along with positive margins and spread outside the capsule ( I fall into the latter category.
User
Posted 25 Jun 2016 at 12:22
Hi David,

I'm going to see the oncologist but don't plan to rush into any treatment unless my post op psa comes back raised - I should have that result mid-week. Some surveys show better results if you have adjuvant treatment before your psa rises above .4 I have been told. But I'm not decided yet.
User
Posted 25 Jun 2016 at 13:37

DW, you could look at Jaypeeca, Christoff, Sanders, Louise1969 or Peterandali for starters - or just put 'seminal vesicles' into the search box and read down all the specific posts where it has been mentioned

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 26 Jun 2016 at 12:28

And of course psa rising after RP could be coz of cells anywhere else in the body, so RT in the prostate bed area would be useless..

User
Posted 26 Jun 2016 at 12:43

I was told I had some seminal vesicle left inside , but not the cause of post op PSA 1.5 rising to 2.4. A PET scan confirmed this was not a hotspot. I rejected the offered RT on the grounds of pre op PSA 43 , post op 1.5 , doubling time 6 1/2 weeks , Gleason 9 , five lymph nodes cancerous. He agreed they were just throwing the kitchen sink at me.

 
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